PAYMENT INTEGRITY

A Precise Approach to Identifying Claim Payment Errors

A More Precise Approach to Identifying Claim Payment Errors

Healthcare spending has exceeded $3 trillion annually. Despite considerable gains in claims payment validation, over $100 billion in wasteful spending still occurs each year. Healthcare claims processing is as profoundly complex as ever and is only made more difficult by numerous EMR vendors and compliance issues.

Overpayment and Recovery

To stop profit leakage and improve bottom line performance, payers need to take a new approach to payment integrity. This is where Consova’s diligent, thoughtful approach to retrospective claims accuracy comes into play. Our team of industry veterans dig deep to find overpayments and recover the funds,while respecting your sensitive provider relationships.

Our payment integrity solutionscomplement your existing reviews with a more thorough examination that often uncovers additional recovery opportunities. Our analysis includes everything from identification and financial resolution to root cause analysis and prevention, resulting in millions of dollars in savings for our payer clients.

We perform in-house collections and utilize partnerships to recover every dollar possible for you. Our main collection partner collects 75% of every identified dollar within 180 days.

Finding Dollars Others Miss

For over 13 years, Consova has been outthinking and outworking the competition. We challenge payers to put their existing auditors to the test by allowing Consova to be the sweeper, even if that has to be on a 100% contingency basis. We will prove our approach to payment integrity is superior by finding payment errors that first and second pass auditors overlook or cannot fathom.

Credit Balance Audit

With Consova’s Credit Balance service, we identify revenue leakage and recapture the lost dollars to the payers through identifying insurance overpayments and claims errors. We preserve your relationship with providers and operate as an independent third party to identify, collect and return payment errors. All of our credit balance and recovery services are offered at no direct cost to the providers. In the convoluted corporate space, a major benefit of partnering with Consova is that we are not affiliated or owned by a health insurance carrier, guaranteeing there is no conflict of interest, and your confidential claims data is not shared with a competitor.